NPI age
19 years
Enumerated 2007-01-18
Across 807 active ophthalmology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (WV) | 13376 | PERMANENT LICENSE |
| 01 (GA) | 044055 | MEDICAL LICENSE |
| 01 (TX) | D2550 | TEXAS MEDICAL LICENSE NUMBER |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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